What is CHF in dogs and how is it treated?

Dr. Susan Baker

Saturday

Oct 7, 2017 at 12:01 AM

Question: My dog Jim is 14 years old and he was diagnosed with heart failure due to degenerative valve disease. He was coughing a lot and losing weight, so I brought him to the veterinarian. He did lots of tests to diagnose the problem. He is on benazapril, vetmedin, and furosemide and is doing much better now. What is the prognosis for him, and am I giving him the correct medication?

Answer: It sounds like Jim is getting good treatment and is on a good plan for his health care.

Congestive heart failure (CHF) and Degenerative valve disease (DVD) are fairly common in older dogs. Up to 60 percent of small-breed dogs will get this problem. It is important to do proper testing to determine the reason for why the heart is failing to pump blood properly. You have done the testing that your doctor recommended in order to detect the problem and fix it as well as possible.

Most dogs with uncomplicated CHF due to degenerative valve disease, like your dog, are treated with similar medications. It is helpful to understand why the heart is failing at pumping enough blood to oxygenate the brain and bodily tissues.

When the mitral valve in an older dog degenerates with age, it tends to become "leaky." This means that it is not closing tightly enough when the heart beats and contracts to push the blood from one heart chamber to another, which causes some of the blood to leak backward into the ventricle of the heart.

Your veterinarian detected this sound as a heart murmur. Not all heart murmurs are significant enough to cause heart failure symptoms. Some heart murmurs are due to other things like anemia. In dogs, panting, excitement, shivering and other factors can mask heart murmurs so they are not detected. Once a heart murmur has been detected, it is prudent to do some diagnostics and follow the development.

At this point, mitral heart murmurs are seldom treated in in the early stages. It is important for you and your veterinarian to continue to evaluate the heart regularly after a murmur develops to determine when intervention with medication will be helpful.

This is often when significant problems develop: It may start as exercise intolerance and proceed to respiratory problems like difficulty breathing or coughing. In extreme situations, it can be life-threatening and your dog’s tongue and gums can turn blue from lack of oxygen. If he can’t get to a veterinarian or emergency clinic quickly, he can die. Informed owners can watch their pets closely and have them evaluated early to get early treatment.

Fortunately, with early diagnosis and treatment, pets with heart issues are living longer and happier lives. Depending on the severity of the valve disease, your pet may live a long time after diagnosis. At this time, CHF is not a disease that we cure, it is a condition that we treat medically and manage as it evolves. The valve will generally get worse as the pet ages and tends to cause more leakage. The heart has to work harder over time.

Most pets will eventually die from this condition, but it may be many months or years before it becomes that severe. My patients usually enjoy a pretty normal lifestyle if they follow guidelines and come in regularly for follow-up examinations and adjustments to their medications. It takes good teamwork with their owner and veterinarian to adjust their routines, diets, therapy, and medication.

First and foremost, I like to start with diet. Heart patients need a diet low in sodium. Salt is the No. 1 thing that makes foods yummy for most dogs and cats as well as other animals. Most food and treats are full of salt and way too high for pets with heart issues.

There are many commercially available diets that work quite nicely for heart patients. I like the Hills Prescription Diet k/d to start. This company realizes that heart patients often have very poor appetites and lose weight. They have come out with some appetite enhancing features in their food that seem to be working well. If your pet doesn’t like this food, there are several more companies that make foods low enough in sodium your veterinarian can suggest.

You can also cook for your pet. I have many clientswho cook for their pet but not for themselves. Most people have trouble balancing the diet with enough vitamins and minerals to keep their pet healthy, but it can be done. Since many CHF pets are getting lots of medications, be careful about what food you are using to give the medication. Cheese and most peanut butter are full of salt.

I recommend salt-free peanut butter to hide pills. You can also use home cooked chicken where no salt was added. Many dogs like carrots, bananas, apples or oranges, and pills can even be placed in a carved out piece of these treats. The medications can also be made into flavorful treats or liquids by a compounding pharmacist.

Omega 3 fatty acids and fish oil type supplements can be helpful to increase calories and may have some supplemental effects. Some people add them to their pets food to stimulate the appetite.

Also, be cautious of what treats or snacks you give your pet. Most commercially available treats don’t list the sodium level on the bag, but they are usually very high levels and should be avoided. Make sure your dog does not get more than 13 mg of sodium per day in treats, and cats should be limited to 3 mg.

Limiting exercise can be helpful to keep your dog from overworking the heart. A little gentle exercise or play can be beneficial to your pet’s well-being. Try some new activities, like puzzle toys and hide-and-seek games that can be done indoors with temperature control to prevent your dog from panting on hot days. Extreme sports should not be attempted. Try gentle walks.

Since most dogs are on diuretics that cause them to urinate frequently, please make sure that they get out every 3 to 4 hours, if possible. Giving him a potty pad or a small patch of indoor grass may be helpful. Hire a dog walker to come over and walk him, or a friend or family member to do an extra walk if you work long hours. Doggie day care could even be an option if he is calm and enjoys going places.

Provide plenty of fresh purified water. Some areas have well water or city water that may be too high in sodium for your dog. Pick up, clean, and refill his water bowl at least twice a day.

Learn how to do a resting respiratory rate on your dog. Keep a journal and notify your veterinarian if you see his respiratory rate increasing. Wait until your pet is lying down and resting comfortably, then count the number of times that his chest goes up and down as one respiration. Count the number of respirations during 30 seconds, and multiply it by two. This will be the number of respirations per minute. Write it in a daily chart.

Bring the chart when you go to your scheduled veterinary examinations with your dog. If his resting rate increases suddenly, call your veterinarian and schedule an exam immediately.

Make sure to keep track of appointments and get his blood checked regularly. Your veterinarian will need blood testing to make sure that the kidneys are tolerating the diuretics and other medications. Chest X-rays or ultrasounds may also be needed from time to time to help balance the medications properly.

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